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NPI Code Detail

MEDICARE: SARA L WALTERS

MEDICARE: SARA L WALTERS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorLCDCIII.162488OH

General Provider Information

NPI Number : 1720509102
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARA L WALTERS
Provider Business Mailing Address
First Line : 100 CROWNE POINT PL
Second Line :
City : CINCINNATI
State : OH
Zip : 45241-5427
Country : US
Telephone Number : 513-743-7628
Fax Number :
Provider Business Practice Location Address
First Line : 1620 HARRISON AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45214-1410
Country : US
Telephone Number : 513-914-4673
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2017
Last Update Date : 02/07/2024

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Directions to “ SARA L WALTERS ” Practice Location

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